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Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials
Objective: To compare the efficacy and safety of olanzapine and risperidone in children and adolescents (aged ≤18 years) with psychosis by conducting a meta-analysis of randomized controlled trials (RCTs). Methods: Several English and Chinese databases were searched for studies published before Febr...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Mary Ann Liebert, Inc.
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952347/ https://www.ncbi.nlm.nih.gov/pubmed/29356569 http://dx.doi.org/10.1089/cap.2017.0120 |
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author | Xia, Lei Li, Wen-Zheng Liu, Huan-Zhong Hao, Rui Zhang, Xiang-Yang |
author_facet | Xia, Lei Li, Wen-Zheng Liu, Huan-Zhong Hao, Rui Zhang, Xiang-Yang |
author_sort | Xia, Lei |
collection | PubMed |
description | Objective: To compare the efficacy and safety of olanzapine and risperidone in children and adolescents (aged ≤18 years) with psychosis by conducting a meta-analysis of randomized controlled trials (RCTs). Methods: Several English and Chinese databases were searched for studies published before February 8th, 2017. Two independent investigators screened the studies according to prespecified criteria and extracted the data. Review Manager 5.3 was used to conduct the data synthesis. Results: Eight RCTs involving 457 participants (225 participants in the olanzapine group and 232 participants in the risperidone group) were included. No significant differences were observed in the mean scores on the Positive and Negative Syndrome Scale/Brief Psychiatric Rating Scale (standard mean difference [SMD] = −0.06, 95% confidence intervals [CI] = [−0.31, 0.19], p = 0.63), the positive symptom scores (SMD = −0.09, 95% CI = [−0.32, 0.15], p = 0.48), or the negative symptom scores (SMD = −0.11 95% CI = [−0.34, 0.13], p = 0.38) between the two groups. Regarding adverse effects, the mean increases in weight (MD = 2.90, 95% CI = [1.41, 4.39], p = 0.0001), body mass index (MD = 0.90, 95% CI = [0.42, 1.38], p = 0.0003), and incidence of hypersomnia (risk ratios [RR] = 1.98, 95% CI = [1.15, 3.43], p = 0.01) were higher in the olanzapine group, while the incidence of insomnia (RR = 0.31, 95% CI = [0.11, 0.85], p = 0.02), prolactin elevation (RR = 0.11, 95% CI = [0.01, 0.85], p = 0.03), myotonia (RR = 0.12, 95% CI = [0.03, 0.49], p = 0.003), tremor (RR = 0.22, 95% CI = [0.08, 0.63], p = 0.005), and akathisia (RR = 0.27, 95% CI = [0.12, 0.57], p = 0.0007) was higher in the risperidone group. Conclusions: There is no significant difference in efficacy between olanzapine and risperidone for the treatment of children and adolescents with psychosis, but the side effect profiles of these two medications differ. High-quality RCTs are needed before recommending clinical treatment in children and adolescents. |
format | Online Article Text |
id | pubmed-5952347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Mary Ann Liebert, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-59523472018-05-16 Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials Xia, Lei Li, Wen-Zheng Liu, Huan-Zhong Hao, Rui Zhang, Xiang-Yang J Child Adolesc Psychopharmacol Original Articles Objective: To compare the efficacy and safety of olanzapine and risperidone in children and adolescents (aged ≤18 years) with psychosis by conducting a meta-analysis of randomized controlled trials (RCTs). Methods: Several English and Chinese databases were searched for studies published before February 8th, 2017. Two independent investigators screened the studies according to prespecified criteria and extracted the data. Review Manager 5.3 was used to conduct the data synthesis. Results: Eight RCTs involving 457 participants (225 participants in the olanzapine group and 232 participants in the risperidone group) were included. No significant differences were observed in the mean scores on the Positive and Negative Syndrome Scale/Brief Psychiatric Rating Scale (standard mean difference [SMD] = −0.06, 95% confidence intervals [CI] = [−0.31, 0.19], p = 0.63), the positive symptom scores (SMD = −0.09, 95% CI = [−0.32, 0.15], p = 0.48), or the negative symptom scores (SMD = −0.11 95% CI = [−0.34, 0.13], p = 0.38) between the two groups. Regarding adverse effects, the mean increases in weight (MD = 2.90, 95% CI = [1.41, 4.39], p = 0.0001), body mass index (MD = 0.90, 95% CI = [0.42, 1.38], p = 0.0003), and incidence of hypersomnia (risk ratios [RR] = 1.98, 95% CI = [1.15, 3.43], p = 0.01) were higher in the olanzapine group, while the incidence of insomnia (RR = 0.31, 95% CI = [0.11, 0.85], p = 0.02), prolactin elevation (RR = 0.11, 95% CI = [0.01, 0.85], p = 0.03), myotonia (RR = 0.12, 95% CI = [0.03, 0.49], p = 0.003), tremor (RR = 0.22, 95% CI = [0.08, 0.63], p = 0.005), and akathisia (RR = 0.27, 95% CI = [0.12, 0.57], p = 0.0007) was higher in the risperidone group. Conclusions: There is no significant difference in efficacy between olanzapine and risperidone for the treatment of children and adolescents with psychosis, but the side effect profiles of these two medications differ. High-quality RCTs are needed before recommending clinical treatment in children and adolescents. Mary Ann Liebert, Inc. 2018-05-01 2018-05-01 /pmc/articles/PMC5952347/ /pubmed/29356569 http://dx.doi.org/10.1089/cap.2017.0120 Text en © Lei Xia et al. 2018; Published by Mary Ann Liebert, Inc. This article is available under the Creative Commons License CC-BY-NC (http://creativecommons.org/licenses/by-nc/4.0). This license permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited. Permission only needs to be obtained for commercial use and can be done via RightsLink. |
spellingShingle | Original Articles Xia, Lei Li, Wen-Zheng Liu, Huan-Zhong Hao, Rui Zhang, Xiang-Yang Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials |
title | Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials |
title_full | Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials |
title_fullStr | Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials |
title_full_unstemmed | Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials |
title_short | Olanzapine Versus Risperidone in Children and Adolescents with Psychosis: A Meta-Analysis of Randomized Controlled Trials |
title_sort | olanzapine versus risperidone in children and adolescents with psychosis: a meta-analysis of randomized controlled trials |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952347/ https://www.ncbi.nlm.nih.gov/pubmed/29356569 http://dx.doi.org/10.1089/cap.2017.0120 |
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